ADHD: A Return to Psychology

Craig B. Wiener, EdD
19
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Welcome! This blog presents a psychological understanding of the diagnostic category “Attention Deficit Hyperactivity Disorder” (ADHD). Over the past decades, professionals have been informing the public about the neurobiological causes of the behaviors, and the necessity to medicate and stringently manage those who have been afflicted. This blog critiques those claims.

While biological determinist claims may continue to prosper there is increasing concern that we are positing the existence of a medical problem when there are no biological markers or dysfunctions that reliably correspond with the behavioral criteria.

Over the coming weeks, I will also present an alternative intervention that develops self-management in individuals who have been diagnosed as ADHD. This intervention is designed to replace traditional treatments which have been yielding very poor longer-term benefits.    

The Fragile Pillars of Biological Causality 

Let’s examine the foundation of ADHD biological determinism. This view speculates that ADHD represents a neurological delay that forever keeps a person from showing competency in self-management. Three research finding (or, as I call them, “pillars”) form the basis of this position.

1) ADHD runs in families

    • Often identical twins are the same when it comes to ADHD.
    • There are studies which suggest that molecular biology increases the likelihood of ADHD.

2) The brain biology of groups of people with ADHD differs from those without ADHD

3) Medicine (which alters biology) ameliorates ADHD

So let’s examine each of these “pillars.”

1) ADHD is genetic

There are individuals with ADHD who do not have the molecular biology associated with ADHD. There are individuals without ADHD who have the genetic material associated with ADHD.

The occurrence of these false positives and negatives indicates that genetics is not the cause of ADHD.

From a psychological viewpoint, we expect that an ADHD (and many other patterns of behavior) will run in families. People in families tend to have similar bodies and experiences, so they are likely to learn in similar ways. This (of course) amplifies with identical twins.

Many behaviors (including poverty) and various psychiatric diagnoses run in families. However, similarity amongst related individuals tells us nothing about how different these people might become with the introduction of different environments.

2)   Brain biology is different for those with ADHD

The finding that ADHD brains (on average) are different shows a correlation between people who respond with ADHD behaviors and certain kinds of biological patterns. Cause and consequence are not determined. 

Yes, endogenous factors may increase the likelihood of developing ADHD behavior. When particular kinds of problems and impairments occur (which make it difficult for people to meet expectations) ADHD behaviors can become prevalent. However, doing ADHD behavior (over time) may also change a person’s biological development just like what happens with muscle mass when people fail to exercise. This outcome is illustrated by Walsh et al. (2014) who show that exposure to environmental stress reduces the size of the cerebellum. It is evident in Maguire et al.  (2000) study which shows that the spatial cortex of cab drivers will show greater develop as a consequence of navigating city streets. And it is made clear in Gaser and Schlaug’s (2003) study which shows that the brain’s “planum temporale” develops as a function of playing a musical instrument.

3)   Medicine is effective

We do not know the etiology a problem just because medicine ameliorates the behaviors. For example, alcohol might help a person to become more sociable, but that does not tell us why the person was not sociable. Treatments do not tell us about causation.

An Alternative Way to Conceptualize ADHD 

There are no dysfunctions of any kind that can be used to make the ADHD diagnosis.  ADHD behaviors occur in particular situations and circumstances and increase in frequency in relation to what happens. Rather than delayed behavior, ADHD behaviors are ways to cope (i.e., reinforced behavior) and, like other behavioral responses, they yield advantages and side effects. 

In this alternative view, the label “ADHD” is affixed when people do particular avoidant and intrusive behaviors more often than others. The behaviors are more likely when individuals are responding to the adversity (often responding to the agendas imposed by others) and least likely when individuals are doing what they initiate and enjoy (situations associated with pleasure and success). 

What is the Role of Biology in this Formulation of ADHD? 

Biology changes the probably of what is learned (e.g., if a person is agile, he is more likely to enjoy playing sports and participate frequently, and if he is clumsy, the opposite is likely).  

However, depending upon life experiences, people with similar biology may learn to live in the world in different ways (e.g., some very agile people might learn to dislike sports). This is why early occurring biology is often a poor predictor of subsequent patterns of behavior (e.g., psychiatric diagnoses). And if people live in the world in a particular way, their biology is likely to reflect the way they live and learn.

Conclusion: 

People with a particular kind of biology may have a slightly greater probability of an ADHD diagnosis. However, experiences along the way can alter the course of development even with this temporal origin. Particular genes and various early occurring problems (e.g., negative infant temperament, high activity levels, motor coordination difficulties, health problems, etc.) can increase the likelihood of an ADHD diagnosis, but these problems do not seal an individual’s fate. People with similar starting points can have different psychological and biological developmental trajectories.


References:

Gaser, C., and G. Schlaug. “Brain Structures Differ between Musicians and Non-Musicians.” The Journal of Neuroscience 23, no. 27 (2003): 9240–45.

Maguire, E. A., D. G. Gadian, I. S. Johnsrude, C. D. Good, J. Ashburner, R. S. Frackowiak, and C. D. Frith. “Navigation-Related Structural Changes in the Hippocampi of Taxi Drivers.” Proceedings of the National Academy of Sciences, USA 97 (2000): 4398–403.

Walsh, N., Dalgleish, T., Lombardo, M., Dunn, V., et al; General and specific effects of early-life psychosocial adversities on adolescent grey matter volume. Neuroimage: Clinical. Volume 4, 2014, Pages 308-318. http://dx.doi.org/10.1016/j.nicl.2014.01.001

19 COMMENTS

  1. They say that alcoholism and these so called mental disorders are genetic and runs in families but doesn’t being Democrat or Republican and left or right political thinking also run in families ?

    Also listen to any good political argument and sooner or later one side will claim the other lacks insight and has broken thinking.

    • “doesn’t being Democrat or Republican and left or right political thinking also run in families ”
      Good point :).
      But that aside: even if there was a small subset of kids who have some propensity to be “hyperactive” due to some genetic mutation a) that doesn’t mean that they should be “fixed” by drugs b) it’s completely meaningless in terms of current practice when 10% (and in some places >25% of boys) are supposedly ADHD. Even if you really wanted to study anything scientifically with the DSM diagnosis it is nonsense and as the article mentions – there is no genetic marker.

  2. Two additional points: first, even if “ADHD” is correlated with a genetic or biological “cause” still does not mean it is a dysfunction or disorder. Being tall or overweight or having blue eyes are all genetically moderated to one degree or another. Short or fat people are treated differently in society and sometimes suffer “symptoms” as result. There is nothing wrong with a short or genetically heavy person – their “symptoms” are a result of the expectations of society and the punishment meted out for not meeting those expectations.

    Second, these so-called “ADHD” kids have been shown to be indistinguishable from “normal” kids in an open classroom where they aren’t being bossed around all the time. The “ADHD” labeling process frees the adults from having to examine the structure of their school institution as a potential causal factor, and also eliminates any real motivation for coming up with structural solutions, even though science has already provided one possible answer. The label serves the adults, not the kids.

    OK, I lied: three points. The last is that the so-called “treatment” has never been shown to improve long-term outcomes for kids with this label. So what’s the point of “treating” them if they’re going to turn out just the same or worse?

    I hope you will discuss social structures and expectations as “causal” factors for ADHD in your coming blogs.

    Thanks for continuing to challenge the conventional “wisdom” on this issue.

    —- Steve

    • I wonder – does being too short or ugly or nerdy or whatever else that can cause you problems in life is a disease? Is everyone now supposed to be a happy clone from the brave new world factory?
      Diseases are supposed to be treated when they affect the individual and not when society doesn’t like something about you. Psychiatry re-defines that: if society treats you like sh*t and that makes you feel bad – you’re the one who needs fixing so you can fit in. How authoritarian is that?

      • Or if a doctor participated in a “bad fix” or “Foul up,” then it’s mandatory the harmed patient be defamed with a fictional disorder and poisoned! How sick is that?

        Or if a pastor wants to cover up child abuse, absolutely the raped individual and / or his family must be stigmatized, tortured, and hopefully killed with major drug interactions!

        Fictitious and unprovable “mental illnesses” were wrong in Nazi Germany. And they are being misused in America today. Psychiatry needs to stop pushing their unprovable eugenics beliefs. The worst of human history is repeating itself.

  3. Younger children in the classroom likely overdiagnosed with ADHD
    Immaturity may lead to diagnosis of disorder (with some in class as much as a year older than the younger children given cutoff dates for enrollments)

    http://www.cmaj.ca/site/misc/pr/5mar12_pr.xhtml

    The fact that this happens routinely shows that any claims that ADHD is a bonafide brain disorder, disease, disability or anything close to being a “mental illness” is fraudulent and predatory to profit at the expense of these children/families. Such younger children may need some additional help, but they should be told the real reason and not be made to feel like some brain damaged mental case, which is very destructive to one’s whole life not to mention the toxic, useless drugs.

    http://www.theatlantic.com/health/archive/2014/07/how-childhood-trauma-could-be-mistaken-for-adhd/373328/

    http://www.theatlantic.com/health/archive/2013/09/adhd-or-(normal)-childhood-narcissism/279660/

    The above adapted from following book:

    Back to Normal: Why Ordinary Childhood Behavior Is Mistaken for ADHD, Bipolar Disorder, and Autism Spectrum Disorder – by Enrico Gnaulati PhD

    http://www.amazon.com/Back-Normal-Ordinary-Childhood-Behavior/dp/0807073342?tag=viglink20242-20

    http://specialedpost.org/2014/02/10/is-adhd-a-problem-of-not-listening/

    http://www.claudiamgoldmd.blogspot.com/2014/06/adhd-at-4-violent-at-15-are-lessons.html

    http://www.claudiamgoldmd.blogspot.com/2014/06/insel-of-nimh-misses-mark-medication-as.html

    And I support Dr. Fraud Baughman, Neurologist and real brain expert, completely when he states that DSM voted in stigmas like ADHD and bipolar inflicted on children and adults now declared INVALID and lacking any science or other evidence by Dr. Thomas Insel, Head of the NIMH, are 100% fraud and the worst medical crimes ever perpetrated against humanity.

    He has written many excellent articles about how psychiatry ended up pursuing this fraudulent DSM path when neurology and psychiatry split with the understanding that the former dealt with real brain diseases/medical brain problems while psychiatry dealt with problems in living. It was only when Freudian analysis waned and the medical doctor of the APA got the smart, psychopathic idea to stress their medical training to hijack the whole mental health system that psychiatry decided to sell out to Big Pharma in the 1980’s and vote in about 300 junk science stigmas including ADHD and bipolar to push the latest lethal drugs on patent as “brain disabling treatments” per Dr. Peter Breggin that this social menace was unleashed with the latest predation for new Big Pharma markets on our children, toddlers, babies in utero and their mothers, the elderly (especially women per usual) and any other vulnerable populations. Robert Spitzer, the narcissistic editor of DSM III focused on treating people like rock specimens in his life destroying “bible” as he did with those in his personal life. He ensured that no environmental, relationship or other social stressors, oppression, racism, sexism, homophobia (to be removed later) or any other injustice, abuse, bullying, mobbing, rape, combat and other traumatic experiences would be considered at all. Spitzer did admit that if any such causes of the bogus stigmas in the DSM were considered the whole house of cards would fall apart. That’s why psychiatry must silence its critics and promote their fraudulent spin that the increasing inequality and predation by the 1% in power on the 99% that is causing so much stress and suffering is all in the victims’ heads or genes or whatever the lie du jour is today to blame the victims of gross injustice and violation of all their democratic, civil and human rights.

    I don’t deny that children and parents may need advice and help with problems of living and better parenting/discipline techniques, but to poison our children with toxic stigmas and drugs shows that our country/globe has lost its moral compass. I am very glad that more doctors and others are speaking out against these human/child atrocities.

  4. Link to Dr. Fred Baughman’s great enlightening book exposing the fraud of ADHD, bipolar and stigmatizing and drugging children in general:

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    The ADHD Fraud: How Psychiatry Makes “Patients” of Normal Children Paperback –
    by Fred A. Baughman Jr. MD (Author), Craig Hovey (Contributor)

    http://www.amazon.com/The-ADHD-Fraud-Psychiatry-Patients/dp/1412064589/ref=cm_cr_pr_product_top

  5. I did the ADHD treatment thing and was high on Dexadrine and Adderal for years and looking back the treatment was only effective in the very beginning then I needed the stuff just to function at the level I was before.

    I can do this online activism thing just fine without Adderal cause I am into it, the schools got the problem not the students.

    Anyway check it out, a clip from the 1998 NIH consensus conference http://youtu.be/MKZXH7MOwjI

    All a parent needs to do is adjust for body weight and take the childs dose and they will be like WTF ? I am not giving THIS to my kid ! but I might want so more of these.

  6. I spent a few days with my young nephews. Their parents had a rather acrimonious divorce. recently the older one (10) went on “ADHD” drugs and he’s already spellbound. He thinks they help him in school. He takes Concerta during the day and has to take a pill to help him sleep at night, too, a blood pressure medication called Catapres. A ten year old on blood pressure meds. The parents are all fine with this. No thought that maybe the divorce and being shuttled from one house to another may have affected this child in any way. I have suggested counseling for the kids (there are two, one is drugged and the mom wants to drug the other) but to no avail…they believe drugs are the answer.
    I think it’s child abuse.

    • Start saving money so he can goto a nice drug treatment center cause most young people in them got addicted ‘spell bound’ starting with psychiatry and the ADHD drugs.

      Don’t believe me ? Then goto a 12 step meeting and ask the young addicts about it, you will see how child psychiatry is a part of most of their stories.

    • Well, amphetamine is also very helpful for students during exam sessions – it’s a well known fact and I remember police raids at my university when chemistry students used to synthesize it (it’s pretty straightforward, a 2nd yr student can easily do that) and sell it to other faculties. Now you can get it legally from the pharmacy.
      “there are two, one is drugged and the mom wants to drug the other”
      And now it will be the evidence on how ADHD runs in the family…

  7. Ask yourself why don’t the Amish get ADHD ?
    Heres how to bypass all the BS.

    1. No Vaccinations (Homeopathy if necessary)( Tell em your christian science if necessary ) Find online info on how to avoid them in your state.
    2.No tranqs,meds,drugs,neuroleptics,speed etc., (Home school if necessary)
    3.No ADA dentistry. Hal Huggins protocol dentistry instead ( especially no mercury or metal installations in mouth.
    4. Traditional Naturopathy as main health advisor
    5. Contact Generation Rescue on line believe them no matter what Quack Watch (which is a pseudo science AMA ,APA ,ADA guild protecting propaganda machine) says. Generation Rescue is the real deal.